Catatonia among elderly: A retrospective study from an inpatient setting of a tertiary care center

Abstract

ABSTRACT Background: There is limited data on the prevalence, symptom profile, and etiology of catatonia among the elderly. Aim: This study aimed to evaluate the prevalence, symptom profile, and primary etiology of catatonia among elderly patients (≥60 years) admitted to an indoor acute care psychiatric unit of a general hospital setting. Methodology: For this retrospective study, the inpatient psychiatry registry of the department for the period of January 2016 and June 2023 was screened to identify elderly patients (aged ≥60 years). The treatment records of these patients were screened for the presence of catatonia. The symptom profile of those with catatonia as per the rating on the Bush Francis Catatonia Rating Scale (BFCRS) and the psychiatric diagnosis made as per the International Classification of Diseases, Tenth Revision was extracted and compared with those without catatonia. Results: Out of the 298 elderly patients admitted to the inpatient unit during the study period, 33 (11.1%) had catatonia at the time of admission. As per BFCRS, the most common catatonic symptoms were mutism (100%), followed by staring (93.9%), immobility (84.8%) and rigidity (84.8%), posturing/catalepsy (69.7%), negativism (66.7%), withdrawal (60.6%), and autonomic abnormality (42.2%). No significant difference was noted among those with and without catatonia in terms of sociodemographic variables. In terms of the etiology of catatonia, in the majority of the patients, catatonia is associated with affective disorder (unipolar > bipolar disorder) (28 out of the 33 patients), followed by dementia (n = 3) and psychotic disorder (n = 2). In terms of management, compared to those without catatonia, those with catatonia more often received benzodiazepines and electroconvulsive therapy. Conclusion: About one-tenth of the elderly admitted to the acute psychiatry inpatient units have catatonia, most of them have retarded catatonia, and the majority of the catatonia among the elderly is associated with affective disorders.